DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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A Randomized, Double-Blind, Parallel- Design, Placebo-and-Active-Controlled, Multicenter, Ascending Dose-Ranging Study of the Safety and Efficacy of Single Doses of Org 41793 in the Treatment of Post-Operative Pain in ASA Class I and II Surgical Inpatients Sponsor: Organon Teknika, Inc. Stafford Smith, Mark, M.D., C.M., FRCP, DABA A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety of Fenoldopam Mesylate in Preser Sponsor: Elan Pharmaceutical, Inc. Sum Ping, Sam T., M.B., Ch.B., FRCA A Phase IIIb, Multi-Center, Open-Label, Randomized Study Comparing the Safety and Efficacy of Dexmedetomidine to Propofol-Based Standard of Care for ICU Sedation Following Coronary Artery Bypass Grafting Surgery Sponsor: Abbott Laboratories Thalmann, Edward D., M.D. Establishing a Multi-Center, Multi- Disciplinary Program for Improving Diver Thermal Protection Hardware in Warm and Cold Water Sponsor: U.S. Navy Oxygen Acceleration of Nitrogen - Oxygen Decompression In Submarine Rescue Sponsor: U.S. Navy Vann, Richard D., Ph.D. Prebreathe Reduction Protocol (PRP) Trials Sponsor: National Aeronautics and Space Administration Determination of Safe Post-Drive Surface Intervals Before Military Free-fall Parachuting Sponsor: U.S. Special Operations Command RESEARCH GRANTS Warner, David S., M.D. Effects Of Allosteric Modulation of Hemoglobin Affinity on Outcome from Cerebral Ischemia Sponsor: Allos Therapeutics, Inc. Extracellular Oxygen Radicals and Ischemic Brain Injury Sponsor: National Institutes of Health Apolipoprotein E and the Ischemic Brain Sponsor: National Institutes of Health Integrated Training in Anesthesiology Research Sponsor: National Institutes of Health Morreene Road Pain Clinic Building Opened November 2000 RESEARCH GRANTS 119
PETER B. BENNETT, Ph.D., D.Sc. Founder, President and CEO, Divers Alert Network Senior Director, Duke Hyperbaric Center Professor of Anesthesiology AREAS OF RESEARCH: Hyperbaric and Diving Medicine Efforts involve administrative and organizational responsibility for the nonprofit Divers Alert Network (DAN), a diving safety and emergency service organization located on Colony Drive at The Peter B. Bennett Center. DAN has a permanent staff of 70 and a budget of over $13 million. It is supported by a membership of over 200,000 divers, the recreational diving industry, and large numbers of dive instructors and stores. Research at DAN ($500,000) has revolved around epidemiology analysis of accidents and deaths of U.S. divers to determine their cause. There are over 1,000 accidents with some 90 deaths per year. The results are analyzed in an annual report and reported at many national and international meetings. DAN is an international organization with DAN Europe, DAN Japan, DAN Australia, DAN Southern Africa and is continuing to expand into South America. Other research projects at DAN have included the use of precordial doppler to determine the presence of bubbles heard in the heart as a warning indicator of decompression illness in divers carrying out normal recreational diving. Project Dive Exploration includes the collection of divers’ profiles and accident data from computers and downloading the data to DAN. This information provides a realistic accident database. Studies are underway in the Hyperbaric Center of the effects of ascent rate on the incidence of decompression illness. Risks due to flying after diving have recently been completed and a paper is in preparation. Studies on the risks of diabetes in diving are being completed. Further DAN 120 LABORATORY PROGRAMS LABORATORY PROGRAMS research work can be found in the reports of Drs. Richard D. Vann and Richard E. Moon. HELENE D. BENVENISTE, M.D., Ph.D. Associate Professor, Department of Anesthesiology Assistant Research Professor, Department of Radiology Assistant Professor, Department of Neurobiology Co-Director, Center for In Vivo Microscopy AREAS OF RESEARCH: Magnetic resonance (MR) imaging of disease processes in the brain and the peripheral nervous system; MR imaging of local anesthesia toxicity Intrathecal lidocaine can potentially cause spinal cord injury in patients undergoing spinal anesthesia. The pathophysiological mechanisms underlying lidocaine-induced neurotoxicity are unknown. It has been hypothesized that lidocaine and other local anesthetics in higher than normal concentration might induce ischemia. We recently showed, by use of MR imaging in the rat, that excessive intrathecal concentrations of lidocaine do not cause spinal cord ischemia. 3-D MR imaging of the paravertebral space in human cadavers Several investigators have attempted to spatially visualize the paravertebral space (PVS) in humans. Most 3D models of the PVS are illustrations based on standard anatomical textbooks. Two-dimensional models of the PVS have been reconstructed by injecting contrast medium into the paravertebral space in vivo or by observing the distribution of dye injected into the paravertebral space in human cadavers. We have constructed a three-dimensional model of the PVS in human cadavers using non-invasive high-resolution magnetic resonance imaging and 3-D visualization algorithms. The 3D PVS models enable our conceptualization of the anatomical complexity of the PVS and facilitate teaching paravertebral blockade. Ongoing investigations are focused on extending the in vitro MR studies into the in vivo domain. Brain biopsy-induced hemorrhage and edema quantified by 3-D MR imaging: Effect of blood pressure In collaboration with Professor Allan H. Friedman, Chief, Division of Neurosurgery, we have conducted an investigation on the effect of mean arterial blood pressure (MABP) on intracerebral hemorrhage and edema after biopsy in the rat brain. We showed that only during acute hypertensive conditions (MABP ≈ 130 mmHg) does large intracerebral hemorrhages occur after biopsy. Defining neuropathology with MR microscopy: sensitivity and specificity This project is focused on creating a database of MR images illustrating specific brain pathologies. Dr. Benveniste is directing the neuropathology core of the Duke Center for In Vivo Microscopy and is systematically creating a neuroimaging database that will make explicit connection between MR images and specific pathologies. Currently the following pathologies are being characterized by MR: (a) Neuritic plaques in Alzheimer's disease; (b) hippocampal atropy; (c) ventricular enlargement and (d) gliosis. References to support this research are found in the Publication Section of this annual report. FRANK H. KERN, M.D., FCCM Chief, Division of Pediatric Anesthesia and Critical Care Medicine Professor of Anesthesiology Professor of Pediatrics AREAS OF RESEARCH: Brain, Lung, and Total Body Endothelial Injury During Pediatric Cardiac Surgery. Brain and Lung Inflammatory Effects of CPB.
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DEPARTMENT OF ANESTHESIOLOGY Duke U
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This issue is dedicated to the memo
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DUKE DEPARTMENT OF ANESTHESIOLOGY M
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FACULTY, RESIDENTS, FELLOWS, AND CR
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FACULTY Thomas E. Buchheit, M.D. Cl
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FACULTY Joel S. Goldberg, M.D. Assi
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FACULTY John C. Keifer, M.D. Associ
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FACULTY Joseph P. Mathew, M.D. Asso
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FACULTY Claude A. Piantadosi, M.D.
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FACULTY Mark Stafford-Smith, M.D.,
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FACULTY Christopher C. Young, M.D.,
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20 FACULTY DUKE UNIVERSITY HEALTH S
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AFFILIATED FACULTY Scott T. Howell,
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Edmond C. Bloch, M.B., Ch.B. Associ
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INTERNS Atilio Barbeito, M.D. Abiga
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RESIDENTS John D. Mitchell, M.D. CA
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RESIDENTS CA-3 Tarsha V. Garvin, M.
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Paula D. Alford, B.A., CRNA Beatric
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CRNA Deborah J. Ferrero-Conover, CR
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CRNA Carolyn C. Knoop, CRNA, MSN Da
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CRNA Kena B. Sigman, CRNA, MSN Tede
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40 DUKE ANESTHESIA FACULTY WHO BECA
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CLINICAL ACTIVITIES Infraclavicular
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CLINICAL ACTIVITIES CARDIOTHORACIC
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CLINICAL ACTIVITIES Goals for 2000
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CLINICAL ACTIVITIES Narda D. Crough
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CLINICAL ACTIVITIES returned home t
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CLINICAL ACTIVITIES GENERAL, VASCUL
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CLINICAL ACTIVITIES some of the ser
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CLINICAL ACTIVITIES years, has comb
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CLINICAL ACTIVITIES Molecular Biolo
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CLINICAL ACTIVITIES ORTHOPAEDICS, P
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CLINICAL ACTIVITIES OTOLARYNGOLOGY,
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CLINICAL ACTIVITIES PAIN MANAGEMENT
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CLINICAL ACTIVITIES therapy. This y
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Page 77 and 78: BIOSTATISTICS AND CLINICAL OUTCOME
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Page 86 and 87: Several advances in the residency c
Page 88 and 89: The Annual Resident Graduation and
Page 90 and 91: Lectures, Conferences and Didactics
Page 104 and 105: 2000 BUSINESS OFFICE ANNUAL REPORT
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Page 116 and 117: Magnesium neuroprotection in cardia
Page 118 and 119: Active Institutional Animal Care an
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Page 128 and 129: services to pharmaceutical companie
Page 130 and 131: Gerontological Research in Anesthes
Page 132 and 133: Masaya Kudo, M.D. Daniel Morris, Ph
Page 134 and 135: RESEARCH ASSISTANT Amy L. Kondyra V
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Page 144 and 145: Taekman JM, Web alert. Current Anes
Page 146 and 147: Robertson KM. Donor management. Pro
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Page 150 and 151: Rosemary W. Cumbie Special Assistan
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DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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